This article draws attention to several common mistakes in thinking about biomedical enhancement, mistakes that are made even by some supporters of enhancement. We illustrate these mistakes by examining objections that John Harris has recently raised against the use of pharmacological interventions to directly modulate moral decision-making. We then apply these lessons to other influential figures in the debate about enhancement. One upshot of our argument is that many considerations presented as powerful objections to enhancement are really strong considerations in (...) favour of biomedical enhancement, just in a different direction. Another upshot is that it is unfortunate that much of the current debate focuses on interventions that will radically transform normal human capacities. Such interventions are unlikely to be available in the near future, and may not even be feasible. But our argument shows that the enhancement project can still have a radical impact on human life even if biomedical enhancement operated entirely within the normal human range. (shrink)

The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the diminishment of a capacity or function, under the right set of circumstances, could plausibly contribute (...) to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a welfarist conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing. (shrink)

BackgroundWhether patients in the vegetative state (VS), minimally conscious state (MCS) or the clinically related locked-in syndrome (LIS) should be kept alive is a matter of intense controversy. This study aimed to examine the moral attitudes of lay people to these questions, and the values and other factors that underlie these attitudes.MethodOne hundred ninety-nine US residents completed a survey using the online platform Mechanical Turk, comprising demographic questions, agreement with treatment withdrawal from each of the conditions, agreement with a series (...) of ethical principles and three personality tests.ResultsMore supported treatment withdrawal from VS (40.2 % agreed, 17.6 % disagreed) than MCS (20.6 %, 41.2 %) or LIS (25.3 %, 35.8 %). Agreement with treatment withdrawal was negatively correlated with religiosity (r = −0.272, P < 0.001), though showed no significant relationship with need for cognition or empathy, and only a partial association with utilitarian judgment in a standard moral dilemma. Support for treatment withdrawal was most strongly associated with endorsement of the importance of patient autonomy, dignity, suffering, best interests. Distributive justice was not given significant weight by most. Importantly, agreement with treatment withdrawal was noticeably higher when considered from a first as opposed to third person perspective for VS (Z = −6.056, P < 0.001), MCS (Z = −6.746, P < 0.001) and LIS (Z = −6.681, P < 0.001).ConclusionLay attitudes to withdrawal of treatment in brain damaged patients are largely shaped by values similar to those central to the secular ethical debate. Neither traditional values such as the sanctity of life nor utilitarian values relating to resource allocation seem to play a central role. Far greater weight is given to autonomy, which may explain why participants were far more willing to endorse withdrawal of treatment when the issue was presented in the first person, or in relation to a concrete case involving a patient’s explicit wishes. Surveys focusing on abstract cases presented in the third person may not provide an accurate picture of lay attitudes to these critical ethical questions. (shrink)

Opponents of biomedical enhancement frequently adopt what Allen Buchanan has called the “Personal Goods Assumption.” On this assumption, the benefits of biomedical enhancement will accrue primarily to those individuals who undergo enhancements, not to wider society. Buchanan has argued that biomedical enhancements might in fact have substantial social benefits by increasing productivity. We outline another way in which enhancements might benefit wider society: by augmenting civic virtue and thus improving the functioning of our political communities. We thus directly confront critics (...) of biomedical enhancement who argue that it will lead to a loss of social cohesion and a breakdown in political life. (shrink)

Katarzyna de Lazari-Radek and Peter Singer argue that evolutionary considerations can resolve Sidgwick’s dualism of practical reason because such considerations debunk moral views that give weight to self-interested or partial considerations but cannot threaten the principle of universal benevolence. I argue that even if we grant these claims, this appeal to evolution is ultimately self-defeating. De Lazari-Radek and Singer face a dilemma. Either their evolutionary argument against partial morality succeeds, but then we need to also give up our conviction that (...) suffering is bad; or there is a way to defend this conviction, but then their argument against partiality fails. Utilitarians, I suggest, should resist the temptation to appeal to evolutionary debunking arguments. (shrink)

Some have objected to human enhancement on the grounds that it violates the autonomy of the enhanced. These objections, however, overlook the interesting possibility that autonomy itself could be enhanced. How, exactly, to enhance autonomy is a difficult problem due to the numerous and diverse accounts of autonomy in the literature. Existing accounts of autonomy enhancement rely on narrow and controversial conceptions of autonomy. However, we identify one feature of autonomy common to many mainstream accounts: reasoning ability. Autonomy can then (...) be enhanced by improving people’s reasoning ability, in particular through cognitive enhancement; given how valuable autonomy is usually taken to be, this gives us extra reason to pursue such cognitive enhancements. Moreover, autonomy-based objections will be especially weak against such enhancements. As we will argue, those who are worried that enhancements will inhibit people’s autonomy should actually embrace those enhancements that will improve autonomy. (shrink)

This dissertation focuses on the concept of authenticity and its implications for our projects of self-creation, particularly those involving the use of "enhancement technologies" . After an introduction to the concept of authenticity and the enhancement debate in the first part of the thesis, part 2 considers the main analyses of authenticity in the contemporary philosophical literature. It begins with those emphasizing self-creation , and shows that, despite their merits, such views cannot adequately deal with certain types of cases, which (...) require a third option, “true self” accounts, emphasizing self-discovery . However, it is argued that in their existing versions, accounts of this third sort are also unsatisfactory. Part 3 of the thesis proposes a new account of the "true self" sort, intended to improve upon existing ones. Common problematic assumptions about the concept of the true self are critiqued, after which a new analysis of that concept is presented, based on seven different conditions. Two specific definitions of authenticity, respectively emphasizing self-expression and the preservation of one's true self, are provided, and its relation to various associated notions, such as integrity or sincerity, are examined. Finally, part 4 looks at the implications of the previous parts for the enhancement debate. In particular, it discusses the prospect of technologically enhancing our personality and mood dispositions. Do such interventions always threaten our authenticity, as some worry? A negative answer is provided to that question. Various potential pitfalls hinted at by the inauthenticity worry are discussed and acknowledged. It is, however, argued that such enhancements could still in principle be used in a fully authentic manner, and that they have the potential to bring about genuine improvements in our mood but also to our moral capacities and our affective rationality more generally. (shrink)

Mackie drew attention to the distinct semantic and metaphysical claims made by metaethical realists, arguing that although our evaluative discourse is cognitive and objective, there are no objective evaluative facts. This distinction, however, also opens up a reverse possibility: that our evaluative discourse is antirealist, yet objective values do exist. I suggest that this seemingly farfetched possibility merits serious attention; realism seems committed to its intelligibility, and, despite appearances, it isn‘t incoherent, ineffable, inherently implausible or impossible to defend. I argue (...) that reflection on this possibility should lead us to revise our understanding of the debate between realists and antirealists. It is not only that the realist‘s semantic claim is insufficient for realism to be true, as Mackie argued; it‘s not even necessary. Robust metaethical realism is best understood as making a purely metaphysical claim. It is thus not enough for antirealists to show that our discourse is antirealist. They must directly attack the realist‘s metaphysical claim. (shrink)

The universe that surrounds us is vast, and we are so very small. When we reflect on the vastness of the universe, our humdrum cosmic location, and the inevitable future demise of humanity, our lives can seem utterly insignificant. Many philosophers assume that such worries about our significance reflect a banal metaethical confusion. They dismiss the very idea of cosmic significance. This, I argue, is a mistake. Worries about cosmic insignificance do not express metaethical worries about objectivity or nihilism, and (...) we can make good sense of the idea of cosmic significance and its absence. It is also possible to explain why the vastness of the universe can make us feel insignificant. This impression does turn out to be mistaken, but not for the reasons typically assumed. In fact, we might be of immense cosmic significance—though we cannot, at this point, tell whether this is the case. (shrink)

Ethical theory often starts with our intuitions about particular cases and tries to uncover the principles that are implicit in them; work on the ‘trolley problem’ is a paradigmatic example of this approach. But ethicists are no longer the only ones chasing trolleys. In recent years, psychologists and neuroscientists have also turned to study our moral intuitions and what underlies them. The relation between these two inquiries, which investigate similar examples and intuitions, and sometimes produce parallel results, is puzzling. Does (...) it matter to ethics whether its armchair conclusions match the psychologists’ findings? I argue that reflection on this question exposes psychological presuppositions implicit in armchair ethical theorising. When these presuppositions are made explicit, it becomes clear that empirical evidence can (and should) play a positive role in ethical theorising. Unlike recent assaults on the armchair, the argument I develop is not driven by a naturalist agenda, or meant to cast doubt on the reliability of our moral intuitions; on the contrary, it is even compatible with non-naturalism, and takes the reliability of intuition as its premise. The argument is rather that if our moral intuitions are reliable, then psychological evidence should play a surprisingly significant role in the justification of moral principles. (shrink)

In an intriguing essay, G. A. Cohen has defended a conservative bias in favour of existing value. In this paper, we consider whether Cohen’s conservatism raises a new challenge to the use of human enhancement technologies. We develop some of Cohen’s suggestive remarks into a new line of argument against human enhancement that, we believe, is in several ways superior to existing objections. However, we shall argue that on closer inspection, Cohen’s conservatism fails to offer grounds for a strong sweeping (...) objection to enhancement, and may even offer positive support for forms of enhancement that preserve valuable features of human beings. Nevertheless, we concede that Cohen’s arguments may suggest some plausible and important constraints on the modality of legitimate and desirable enhancements. (shrink)

Noradrenergic pathways are involved in mediating the central and peripheral effects of physiological arousal. The aim of the present study was to investigate the role of noradrenergic transmission in moral decision-making. We studied the effects in healthy volunteers of propranolol (a noradrenergic beta-adrenoceptor antagonist) on moral judgement in a set of moral dilemmas pitting utilitarian outcomes (e.g., saving five lives) against highly aversive harmful actions (e.g., killing an innocent person) in a double-blind, placebo-controlled, parallel group design. Propranolol (40 mg orally) (...) significantly reduced heart rate, but had no effect on self-reported mood. Importantly, propranolol made participants more likely to judge harmful actions as morally unacceptable, but only in dilemmas where harms were ‘up close and personal’. In addition, longer response times for such personal dilemmas were only found for the placebo group. Finally, judgments in personal dilemmas by the propranolol group were more decisive. These findings indicate that noradrenergic pathways play a role in responses to moral dilemmas, in line with recent work implicating emotion in moral decision-making. However, contrary to current theorising, these findings also suggest that aversion to harming is not driven by emotional arousal. Our findings are also of significant practical interest given that propranolol is a widely used drug in different settings, and is currently being considered as a potential treatment for post-traumatic stress disorder in military and rescue service personnel. (shrink)

Recent research on moral decision-making has suggested that many common moral judgments are based on immediate intuitions. However, some individuals arrive at highly counterintuitive utilitarian conclusions about when it is permissible to harm other individuals. Such utilitarian judgments have been attributed to effortful reasoning that has overcome our natural emotional aversion to harming others. Recent studies, however, suggest that such utilitarian judgments might also result from a decreased aversion to harming others, due to a deficit in empathic concern and social (...) emotion. The present study investigated the neural basis of such indifference to harming using functional neuroimaging during engagement in moral dilemmas. A tendency to counterintuitive utilitarian judgment was associated both with ‘psychoticism’, a trait associated with a lack of empathic concern and antisocial tendencies, and with ‘need for cognition’, a trait reflecting preference for effortful cognition. Importantly, only psychoticism was also negatively correlated with activation in the subgenual cingulate cortex (SCC), a brain area implicated in empathic concern and social emotions such as guilt, during counterintuitive utilitarian judgments. Our findings suggest that when individuals reach highly counterintuitive utilitarian conclusions, this need not reflect greater engagement in explicit moral deliberation. It may rather reflect a lack of empathic concern, and diminished aversion to harming others. (shrink)

According to Joshua Greene’s influential dual process model of moral judgment, different modes of processing are associated with distinct moral outputs: automatic processing with deontological judgment, and controlled processing with utilitarian judgment. This paper aims to clarify and assess Greene’s model. I argue that the proposed tie between process and content is based on a misinterpretation of the evidence, and that the supposed evidence for controlled processing in utilitarian judgment is actually likely to reflect generic deliberation which, ironically, is incompatible (...) with a utilitarian outlook. This alternative proposal is further supported by the results of a recent neuroimaging study we have done. (shrink)

Much seems to be at stake in metaphysical questions about, for example, God, free will or morality. One thing that could be at stake is the value of the universe we inhabit—how good or bad it is. We can think of competing philosophical positions as describing possibilities, ways the world might turn out to be, and to which value can be assigned. When, for example, people hope that God exists, or fear that we do not possess free will, they express (...) attitudes towards these possibilities, attitudes that presuppose answers to questions about their comparative value. My aim in this paper is to distinguish these evaluative questions from related questions with which they can be confused, to identify structural constraints on their proper pursuit, and to address objections to their very coherence. Answers to such evaluative questions offer one measure of the importance of philosophical disputes. (shrink)

Many believe that severe intellectual impairment, blindness or dying young amount to serious harm and disadvantage. It is also increasingly denied that it matters, from a moral point of view, whether something is biologically normal to humans. We show that these two claims are in serious tension. It is hard explain how, if we do not ascribe some deep moral significance to human nature or biological normality, we could distinguish severe intellectual impairment or blindness from the vast list of seemingly (...) innocent ways in which we fail to have as much wellbeing as we could, such not having super-intelligence, or not living to 130. We consider a range of attempts to draw this intuitive normative distinction without appealing to normality. These, we argue, all fail. But this doesn't mean that we cannot draw this distinction or that we must, implausibly, conclude that biological normality does possess an inherent moral importance. We argue that, despite appearances, it is not biological normality but rather statistical normality that, although lacking any intrinsic moral significance, nevertheless makes an important moral difference in ways that explain and largely justify the intuitive distinction. (shrink)

Neuroimaging studies on moral decision-making have thus far largely focused on differences between moral judgments with opposing utilitarian (well-being maximizing) and deontological (duty-based) content. However, these studies have investigated moral dilemmas involving extreme situations, and did not control for two distinct dimensions of moral judgment: whether or not it is intuitive (immediately compelling to most people) and whether it is utilitarian or deontological in content. By contrasting dilemmas where utilitarian judgments are counterintuitive with dilemmas in which they are intuitive, we (...) were able to use functional magnetic resonance imaging to identify the neural correlates of intuitive and counterintuitive judgments across a range of moral situations. Irrespective of content (utilitarian/deontological), counterintuitive moral judgments were associated with greater difficulty and with activation in the rostral anterior cingulate cortex, suggesting that such judgments may involve emotional conflict; intuitive judgments were linked to activation in the visual and premotor cortex. In addition, we obtained evidence that neural differences in moral judgment in such dilemmas are largely due to whether they are intuitive and not, as previously assumed, to differences between utilitarian and deontological judgments. Our findings therefore do not support theories that have generally associated utilitarian and deontological judgments with distinct neural systems. (shrink)

There are many ways that biological theory can inform ethical discussions of genetic engineering and biomedical enhancement. In this essay, we highlight some of these potential contributions, and along the way provide a synthetic overview of the papers that comprise this special issue. We begin by comparing and contrasting genetic engineering with programs of selective breeding that led to the domestication of plants and animals, and we consider how genetic engineering differs from other contemporary biotechnologies such as embryo selection. We (...) go on to consider the implications of genetic engineering for human nature, human evolution, and persistence of the human species. Finally, we question whether genetic interventions warrant the extraordinary ethical scrutiny they are often given, and we show how the misleading “genetic blueprint” metaphor has imposed a faulty structure on the enhancement debate. We conclude by considering the nature of biological development and the sobering limits it places on what genetic engineering can reasonably hope to achieve. (shrink)

Questions about sincerity play a central role in our lives. But what makes an assertion insincere? In this paper we argue that the answer to this question is not as straightforward as it has sometimes been taken to be. Until recently the dominant answer has been that a speaker makes an insincere assertion if and only if he does not believe the proposition asserted. There are, however, persuasive counterexamples to this simple account. It has been proposed instead that an insincere (...) assertion that p is one made by a speaker who (a) does not express his belief that p; or (b) does not believe that he believes that p; (c) does not assent to p; or (d) does not express any of these cognitive states. We show that these .. (shrink)

Evolutionary debunking arguments (EDAs) are arguments that appeal to the evolutionary origins of evaluative beliefs to undermine their justification. This paper aims to clarify the premises and presuppositions of EDAs—a form of argument that is increasingly put to use in normative ethics. I argue that such arguments face serious obstacles. It is often overlooked, for example, that they presuppose the truth of metaethical objectivism. More importantly, even if objectivism is assumed, the use of EDAs in normative ethics is incompatible with (...) a parallel and more sweeping global evolutionary debunking argument that has been discussed in recent metaethics. After examining several ways of responding to this global debunking argument, I end by arguing that even if we could resist it, this would still not rehabilitate the current targeted use of EDAs in normative ethics given that, if EDAs work at all, they will in any case lead to a truly radical revision of our evaluative outlook. (shrink)

Several authors have suggested that we cannot fully grapple with the ethics of human enhancement unless we address neglected questions about our place in the world, questions that verge on theology but can be pursued independently of religion. A prominent example is Michael Sandel, who argues that the deepest objection to enhancement is that it expresses a Promethean drive to mastery which deprives us of openness to the unbidden and leaves us with nothing to affirm outside our own wills. Sandel's (...) argument against enhancement has been criticized, but his claims about mastery and the unbidden, and their relation to religion, have not yet received sufficient attention. I argue that Sandel misunderstands the notions of mastery and the unbidden and their significance. Once these notions are properly understood, they have surprising implications. It turns out that the value of openness to the unbidden is not just independent of theism, as Sandel claims, but is in fact not even fully compatible with it. But in any case that value cannot support Sandel's objection to enhancement. This is because it is not enhancement but certain forms of opposition to enhancement that are most likely to express a pernicious drive to mastery. (shrink)

Whether God exists is a metaphysical question. But there is also a neglected evaluative question about God’s existence: Should we want God to exist? Very many, including many atheists and agnostics, appear to think we should. Theists claim that if God didn’t exist things would be far worse, and many atheists agree; they regret God’s inexistence. Some remarks by Thomas Nagel suggest an opposing view: that we should want God not to exist. I call this view anti-theism. I explain how (...) such view can be coherent, and why it might be correct. Anti-theism must be distinguished from the argument from evil or the denial of God’s goodness; it is a claim about the goodness of God’s existence. Anti-theists must claim that it’s a logical consequence of God’s existence that things are worse in certain respects. The problem is that God’s existence would also make things better in many ways. Given that God’s existence is likely to be impersonally better overall, anti-theists face a challenge similar to that facing nonconsequentialists. I explore two ways of meeting this challenge. (shrink)

In general, to enhance something is to raise that thing in degree, intensity, magnitude, or in some sense improve upon it.2 In this context, we are concerned with enhancements, ie amplifications or extensions, of human capabilities, ...

In this paper I present a new argument against internalist theories of practical reason. My argument is inpired by Frank Jackson's celebrated Knowledge Argument. I ask what will happen when an agent experiences pain for the first time. Such an agent, I argue, will gain new normative knowledge that internalism cannot explain. This argument presents a similar difficulty for other subjectivist and constructivist theories of practical reason and value. I end by suggesting that some debates in meta-ethics and in the (...) philosophy of mind might be more closely intertwined than philosophers in either area would like to believe. (shrink)

Neuroscience and psychology have recently turned their attention to the study of the subpersonal underpinnings of moral judgment. In this article we critically examine an influential strand of research originating in Greene's neuroimaging studies of ‘utilitarian’ and ‘non-utilitarian’ moral judgement. We argue that given that the explananda of this research are specific personal-level states—moral judgments with certain propositional contents—its methodology has to be sensitive to criteria for ascribing states with such contents to subjects. We argue that current research has often (...) failed to meet this constraint by failing to correctly ‘fix’ key aspects of moral judgment, criticism we support by detailed examples from the scientific literature. (shrink)

Although most people believe that it is morally wrong to intentionally create children who have an impairment, it is widely held that we cannot criticize such procreative choices unless we find a solution to Parfit’s non-identity problem. I argue that we can. Jonathan Glover has recently argued that, in certain circumstances, such choices would be self-defeating even if morally permissible. I argue that although the scope of Glover’s argument is too limited, it nevertheless directs attention to a moral defect in (...) the attitudes that could motivate such procreative choices, attitudes that, properly characterized, turn out to be person-affecting in character. I conclude by arguing that prospective parents who want to create a child with an impairment face a dilemma. If they want to avoid the charge that their aim is morally defective, they must deny that the desired impairment is harmful. But this would commit them to endorsing the controversial claim that it is morally permissible or even required to turn normal children into impaired ones. (shrink)

It is widely held that it is only contingent that the sensation of pain is disliked, and that when pain is not disliked, it is not intrinsically bad. This conjunction of claims has often been taken to support a subjectivist view of pain’s badness on which pain is bad simply because it is the object of a negative attitude and not because of what it feels like. In this paper, I argue that accepting this conjunction of claims does not commit (...) us to this subjectivist view. They are compatible with an objectivist view of pain’s badness, and with thinking that this badness is due to its phenomenal quality. Indeed, I argue that once the full range of options is in view, the most plausible account of pain is incompatible with subjectivism about value. (shrink)

Neuroimaging studies of brain-damaged patients diagnosed as in the vegetative state suggest that the patients might be conscious. This might seem to raise no new ethical questions given that in related disputes both sides agree that evidence for consciousness gives strong reason to preserve life. We question this assumption. We clarify the widely held but obscure principle that consciousness is morally significant. It is hard to apply this principle to difficult cases given that philosophers of mind distinguish between a range (...) of notions of consciousness and that is unclear which of these is assumed by the principle. We suggest that the morally relevant notion is that of phenomenal consciousness and then use our analysis to interpret cases of brain damage. We argue that enjoyment of consciousness might actually give stronger moral reasons not to preserve a patient's life and, indeed, that these might be stronger when patients retain significant cognitive function. (shrink)

According to what we call the Principle of Procreative Beneficence (PB), couples who decide to have a child have a significant moral reason to select the child who, given his or her genetic endowment, can be expected to enjoy the most well-being. In the first part of this paper, we introduce PB, explain its content, grounds, and implications, and defend it against various objections. In the second part, we argue that PB is superior to competing principles of procreative selection such (...) as that of procreative autonomy. In the third part of the paper, we consider the relation between PB and disability. We develop a revisionary account of disability, in which disability is a species of instrumental badness that is context- and person-relative. Although PB instructs us to aim to reduce disability in future children whenever possible, it does not privilege the normal. What matters is not whether future children meet certain biological or statistical norms, but what level of well-being they can be expected to have. (shrink)

Although religious belief is often claimed to help with physical ailments including pain, it is unclear what psychological and neural mechanisms underlie the influence of religious belief on pain. By analogy to other top-down processes of pain modulation we hypothesized that religious belief helps believers reinterpret the emotional significance of pain, leading to emotional detachment from it. Recent findings on emotion regulation support a role for the right ventrolateral prefrontal cortex , a region also important for driving top-down pain inhibitory (...) circuits. Using functional magnetic resonance imaging in practicing Catholics and avowed atheists and agnostics during painful stimulation, here we show the existence of a context-dependent form of analgesia that was triggered by the presentation of an image with a religious content but not by the presentation of a non-religious image. As confirmed by behavioral data, contemplation of the religious image eneabled the religious group to detach themselves from the experience of pain. Critically, this context-dependent modulation of pain specifically engaged the right VLPFC, whereas group-specific preferential liking of one of the pictures was associated with activation in the ventral midbrain. We suggest that religious belief might provide a framework that allows individuals to engage known pain-regulatory brain processes. (shrink)